When we think of negotiation in pharmacy, we often picture negotiations between a pharmacy owner/manager or a corporate executive from a large chain negotiating reimbursement contracts for pharmacist services. While these types of negotiations are of momentous importance, there are other much more common negotiations undertaken by pharmacists, and pharmacy managers, each and every day. Most transactions and communications involve negotiations of some sort, including motivational interviewing of patients, as well as negotiating with employees for their requests and your supervisor for certain work/practice conditions and salary. Additionally, pharmacists negotiate on a frequent basis with physicians regarding patients’ pharmacotherapy, let alone possible protocols and collaborative working relationships.

Bradley et al discuss interprofessional negotiation in the midst of these health providers playing a so-called “general practitioner-pharmacist game”.¹ The authors claim that despite a mutual interest in optimizing the benefits of medication for patients, the general practitioner (GP) and community pharmacist (CP) often work in isolation from one another, both physically and figuratively. Sources of tension include pharmacy's ‘shopkeeper’ image, traditional medical hierarchies and potential encroachment on professional boundaries. Their study employed qualitative interviews of 20 GPs and 23 CPs located in geographically and demographically different areas of England. The interviews were based on a set of ‘unwritten’ rules, termed the ‘GP‐pharmacist game’, which involves the concept of ‘face‐work’. Key rules of that game include the pharmacist avoiding blaming the GP, using discretion in front of patients, and balancing the necessity and frequency of the communication. The researchers argue that while adhering to the ‘GP‐pharmacist game’ may avoid conflict and ‘get the job done’, it may also constrain efforts to meet wider health care policy aims of a more collaborative relationship.

In their study conclusions, Bradley et al discuss pharmacists doing what they need to do to move things along and in doing so employ avoidance as a conflict resolution strategy. While no one conflict resolution strategy is best at all times, pharmacists should generally seek collaboration (win-win) rather than concede, refuse to acknowledge the other party’s arguments, or even compromise (win-lose). This way, the ultimate benefactor is the patient. Collaboration is often appropriate even when negotiating with other stakeholders in pharmacy mentioned above (eg, peers, supervisors, employees, health plans). All pharmacists negotiate; pharmacy managers must be especially adept at negotiating with various stakeholders and pass on their negotiating skills to other pharmacy employees.

Additional information about Negotiation Skills and Leadership can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Bradley F, Ashcroft DM, Crossley N. Negotiating inter-professional interaction: playing the general practitioner-pharmacist game. Sociol Health Illn. 2018;40:426-444.